Mental health problems in young people with experiences of homelessness and the relationship with health service use: a follow-up study
Mental health problems in young people with experiences of homelessness and the relationship with health service use: a follow-up study
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DOI：
10.1136/ebmental-2014-101810
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发表时间：
2014-08-01
影响因子：
5.2
通讯作者：
van den Bree, Marianne B. M.
中科院分区：
文献类型：
--
作者：
Hodgson, Kate J.;Shelton, Katherine H.;van den Bree, Marianne B. M.
背景 无家可归的年轻人是最脆弱和服务不足的人群之一。 目的 评估英国样本中精神疾病和合并症的患病率，并检查精神疾病与不同类型的医疗服务使用之间的纵向关系。 方法 使用全面的精神病学评估对 90 名有无家可归经历的年轻人进行访谈。参与者在 8-12 个月后进行了随访，并完成了一次访谈，其中包括有关最近使用健康服务的信息（心理健康、急诊室、全科医生、治疗身体问题的医院、药物或酒精服务）。 结果精神疾病的患病率（目前为 88%；终生为 93%）和精神合并症（73%）较高，而心理健康服务的使用率较低（31%）。情绪障碍、精神病和自杀风险与心理健康服务的使用显着相关（分别为 OR 5.21，95% CI 1.64 至 16.58；OR 10.0，CI 1.58 至 94.58；OR 6.25，CI 1.82 至 21.43）。急诊科的使用是根据情绪障碍（OR 5.19，CI 1.68至16.0）、精神病（OR 7.33，CI 1.24至43.29）、焦虑症（OR 2.88，CI 1.04至7.97）、高自杀风险（OR 3.42，CI 1.86至13.67）和合并症（OR 1.41，CI 1.05 至 1.90）。讨论和临床意义 无家可归的年轻人中精神疾病的患病率很高，并且远远高于普通人群中该年龄组的患病率。需要提高对被社会排斥的年轻人等弱势群体提供长期精神问题治疗服务的接受度。
Background Homeless young people represent one of the most vulnerable and underserved populations.Objective To assess the prevalence of psychiatric disorder and comorbidity among a UK sample, and examine the longitudinal relationship between psychiatric conditions and different types of health service use.Methods 90 young people with experiences of homelessness were interviewed using a full psychiatric assessment. Participants were followed up 8-12 months later and completed an interview that included information about recent health service use (mental health, emergency room, general practitioner, hospital for physical problems, drug or alcohol services).Findings The prevalence of psychiatric disorder (88% current; 93% lifetime) and psychiatric comorbidity (73%) was high and that of mental health service use low in comparison (31%). Mood disorders, psychosis and suicide risk were significantly associated with mental health service use (OR 5.21, 95% CI 1.64 to 16.58; OR 10.0, CI 1.58 to 94.58; OR 6.25, CI 1.82 to 21.43, respectively). Emergency department use was predicted by mood disorders (OR 5.19, CI 1.68 to 16.0), psychosis (OR 7.33, CI 1.24 to 43.29), anxiety disorder (OR 2.88, CI 1.04 to 7.97), high-suicide risk (OR 3.42, CI 1.86 to 13.67) and comorbidity (OR 1.41, CI 1.05 to 1.90).Discussion and clinical implications The prevalence of psychiatric disorders in homeless young people was high and considerably higher than that reported for this age group in the general population. There is a need for improved uptake of services delivering longer term treatment of psychiatric problems among vulnerable groups of socially excluded young people.